Entity Details

Basic

Entity Type:
Free Standing NF/SNF (Free Standing NF/SNF)

Medicaid #:
0808287

CCN #:
165223

Occupancy Type:
Beds

Max Occupancy:
60

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
900335

Initial License Date:

Current License Date:
08/01/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/31/2024

Months Since Last Survey:
6

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1977 Albia Road

City:
Ottumwa

State:
Iowa

Zip:
52501-3708

Phone:
(641) 683-3111

Fax:
(641) 682-8670

URL:

Administrator/License #:
Josh Chambers / 118744

Administrator Email:
jchambers@careinitiatives.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: